Article

OBJECTIVE: To examine the criterion-related validity of using the self-reported
Houghton Scale to classify community-dwelling people with lower-limb amputation
according to the suggested score ranges for independent community (Houghton Scale
score >/=9), household and limited community (Houghton Scale scores 6-8), and
limited household (Houghton Scale score </=5) walking ability categories as
referenced to performance-based balance ability and walking speed criteria.
DESIGN: Cross-sectional cohort study. SETTING: Community-based wellness walking
programs in 8 states in the Mid-Atlantic, Midwest, and Southeast regions of the
U.S. PARTICIPANTS: Volunteers (N=180; 66.5% men, n=118; mean age, 55.5+/-16y)
7.1+/-13.1 years since amputation, with transtibial-level amputation in 47%
(n=79) and amputation caused by vascular disease in 49.4% (n=89). INTERVENTIONS:
None. MAIN OUTCOME MEASURES: Self-reported data: Houghton Scale, Prosthetic
Evaluation Questionnaire mobility subscale, and Activities-specific Balance
Confidence (ABC) Scale. Clinical performance-based measures: balance ability
assessed with 3 Berg Balance Scale (BBS) items and walking ability assessed with
the timed Up and Go (TUG) test and 2-minute walk test (2MWT). The primary
reference criteria were performance-based balance ability measured with the 3 BBS
items and gait speed calculated from the 2MWT. RESULTS: On the Houghton Scale,
45.9% (78/170) of the participants scored >/=9, 30.6% (52/170) of the
participants scored between 6 and 8, and 23.5% (40/170) of the participants
scored </=5. The Houghton Scale correlated with the Prosthetic Evaluation
Questionnaire mobility subscale (r=.73), ABC Scale (r=.76), balance ability
(r=.67), TUG test (r=-.67), and 2MWT (r=.73). The 3 Houghton Scale ability
categories differed significantly from each other (P<.05) for all outcome
measures: Prosthetic Evaluation Questionnaire mobility subscale, ABC Scale,
balance ability, TUG test, and 2MWT. CONCLUSIONS: The Houghton Scale demonstrated
criterion-related validity by differentiating community-dwelling people with
lower-limb amputation into community, limited community/household, and household
ability categories that corresponded to performance-based balance and walking
criteria. Average prosthetic walking speeds for each category compared with
similar walking ability categories defined in other patient populations.
CI - Copyright (c) 2016 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS